Publication: Accelerating Progress towards Achieving the MDG to Improve Maternal Health : A Collection of Promising Approaches
Loading...
Date
2005-04
ISSN
Published
2005-04
Author(s)
Editor(s)
Abstract
One of the Millennium Development Goals (MDG) is to improve maternal health, with the target of reducing maternal mortality by three-quarters between 1990 and 2015. In an effort to accelerate progress towards achieving this MDG, this paper brings together high-quality information on a wide range of promising approaches that aim to improve maternal health outcomes. These global promising approaches, based on field research and practice by experienced organizations working in this arena, can serve as a useful starting point in the process to improve current maternal health programming. This paper will be useful for World Bank staff when assisting client countries in developing their National Poverty Reduction Strategy Papers (PRSPs) and costing health sector plans. Moreover, the paper provides Bank staff with substantive evidence to share with governments on how best to prioritize and implement maternal health programs, and scale up efforts to achieve progress. Although primarily intended for use by Bank staff, we hope this guide will also be useful to governments, other international donor agencies, and nongovernmental organizations (NGOs), who are interested in improving maternal health, and minimizing the disparities that currently exist between industrialized and developing countries.
Link to Data Set
Citation
“Nanda, Geeta; Switlick, Kimberly; Lule, Elizabeth. 2005. Accelerating Progress towards Achieving the MDG to Improve Maternal Health : A Collection of Promising Approaches. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank. http://hdl.handle.net/10986/13702 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Achieving the Millennium Development Goal of Improving Maternal Health : Determinants, Interventions and Challenges(World Bank, Washington, DC, 2005-03)This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. The paper finds that key interventions to improve maternal and reproductive health and reduce maternal mortality include the following mutually reinforcing strategies: (a) mobilizing political commitment and fostering an enabling policy environment; (b) investing in social and economic development such as female education, poverty reduction, and improvements in women's status; (c) providing family planning services; (d) ensuring quality antenatal care, skilled attendance during childbirth, and availability of emergency obstetric services for pregnancy complications; and (e) strengthening the health system and community involvement. The paper emphasizes that carrying out interventions remains a challenge in environments where political commitment, policies, as well as institutions and health systems, are weak. The paper concludes with guiding lessons from some of the countries that have successfully improved maternal health and with a discussion of some of the difficulties of measuring maternal mortality and morbidity outcomes.Publication Universal Maternal Health Coverage? Assessing the Readiness of Public Health Facilities to Provide Maternal Health Care in Indonesia(World Bank, Jakarta, 2014-07)Over the period 2011-2013, Indonesia had universal maternal health coverage for its population. Facility-based deliveries, however, remain relatively low: only about 63 percent of all deliveries occurred at a health facility in Indonesia. Recent progress notwithstanding, and despite the relatively high utilization rates for most key maternal health services, the level of maternal mortality remains high in Indonesia, especially in provinces such as West Papua, North Maluku, Papua, Gorontalo, West Sulawesi, Maluku, and South Kalimantan. This policy paper assesses the supply-side readiness of Indonesia s public health facilities in providing key maternal health services such as antenatal care (ANC) as well as basic and comprehensive emergency obstetric care. The focus in the paper is on assessing to what extent Indonesia's universal maternal health coverage is real. Ensuring the supply-side readiness of Indonesia's health system, incorporating lessons from the past experiences of implementing universal maternal health coverage under the different social health insurance programs, will be one key factor in ensuring that implementation of universal health coverage (UHC) results in improvements in health outcomes, including for maternal health. The policy paper is structured as follows: the section maternal health in Indonesia provides background on maternal health in Indonesia and on intended reforms to attain UHC by 2019. Assessing universal maternal health coverage in Indonesia provides information on maternal health benefits under existing social health insurance programs. Public facility supply-side service readiness for maternal health outlines the supply-side implications of maternal health coverage using national guidelines as well as the World Health Organization's (WHO's) service availability and readiness assessment (SARA) framework, focusing specifically on ANC as well as basic and emergency obstetric care services and presents an assessment of service readiness using facility-level data. The report concludes with policy implications in the final section, policy implications and conclusions.Publication Fertility Regulation Behaviors and Their Costs : Contraception and Unintended Pregnancies in Africa and Eastern Europe & Central Asia(World Bank, Washington, DC, 2007-12)The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (Nigeria and Kazakhstan) on the costs of fertility regulation behaviors and provider attitudes towards contraceptive use. Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe have increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception. Investing in quality family planning programs is a cost-effective way to address unmet need for contraception and reduce the risks of unsafe abortion, thereby improving maternal health. If contraception were provided to the 137 million women who lack access, maternal mortality will decline by 25-35 percent.Publication Investing in Maternal Health : Learning from Malaysia and Sri Lanka(Washington, DC: World Bank, 2003)This study provides the most comprehensive and detailed analysis available on factors behind the decline in maternal mortality in Malaysia and Sri Lanka in the past 50 to 60 years and the magnitude of health system expenditures on maternal health. The main findings are that a modest investment in maternal health services, combined with other poverty reduction measures leads to a fairly rapid decline in the maternal mortality ratio (MMR), defined as the number of maternal deaths per 100,000 live births. The strategies of Malaysia and Sri Lanka changed over time, from an initial emphasis on expanding the provision of services, especially in underserved areas, to increasing utilization and, finally, to emphasizing the improvement of quality. Removing financial barriers to maternal care for clients was an important step in both countries. Professional midwives constitute the backbone of maternal care in Malaysia and Sri Lanka. The MMR reduction in developing countries is feasible with modest public expenditures when appropriate policies are adopted, focused wisely, and adapted incrementally in response to environmental conditions and systems capacity.Publication Maternal Mortality(Washington, DC, 2006-05)Over 529,000 women die annually from complications during pregnancy, childbirth, or the postpartum period. Nearly all of these deaths occur in developing countries, where fertility rates are higher and a woman's life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries. Additionally, an estimated 20 million women endure lifelong disabilities such as pelvic pain, incontinence, obstetric fistula, anemia and infertility. The main direct causes of maternal death are severe bleeding, unsafe abortion, infection, eclampsia, and obstructed labor; the indirect causes include anemia, malaria, heart disease, and HIV. Pregnancy complications are the main cause of death for women aged 15-19. High maternal mortality rates in many countries result from poor reproductive health care, including not having access to skilled care during pregnancy and childbirth and access to safe abortion even where it is legal, especially for the poorest women. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty, low status of women, lack of education, poor nutrition, heavy workloads and violence. While many factors contribute to maternal death, one of the most effective means of preventing maternal health is to improve health systems and primary health care to ensure availability of skilled attendance at all levels and access to 24-hour emergency obstetric care. Family planning services could also reduce maternal deaths and morbidities by 30 percent. Prevention of unwanted pregnancies and access to safe abortion as allowed by law and post abortion care services could reduce maternal deaths and injuries caused by unsafe abortions - over 68,000 women die from unsafe abortions annually.
Users also downloaded
Showing related downloaded files
Publication Poverty and Shared Prosperity 2022(Washington, DC : World Bank, 2022)Poverty and Shared Prosperity 2022: Correcting Course provides the first comprehensive analysis of the pandemic’s toll on poverty in developing countries. It identifies how governments can optimize fiscal policy to help correct course. Fiscal policies offset the impact of COVID-19 on poverty in many high-income countries, but those policies offset barely one quarter of the pandemic’s impact in low-income countries and lower-middle-income countries. Improving support to households as crises continue will require reorienting protective spending away from generally regressive and inefficient subsidies and toward a direct transfer support system—a first key priority. Reorienting fiscal spending toward supporting growth is a second key priority identified by the report. Some of the highest-value public spending often pays out decades later. Amid crises, it is difficult to protect such investments, but it is essential to do so. Finally, it is not enough just to spend wisely - when additional revenue does need to be mobilized, it must be done in a way that minimizes reductions in poor people’s incomes. The report highlights how exploring underused forms of progressive taxation and increasing the efficiency of tax collection can help in this regard. Poverty and Shared Prosperity is a biennial series that reports on global trends in poverty and shared prosperity. Each report also explores a central challenge to poverty reduction and boosting shared prosperity, assessing what works well and what does not in different settings. By bringing together the latest evidence, this corporate flagship report provides a foundation for informed advocacy around ending extreme poverty and improving the lives of the poorest in every country in the world. For more information, please visit worldbank.org/poverty-and-shared-prosperity.Publication The Road to Results : Designing and Conducting Effective Development Evaluations(World Bank, 2009-12-01)The analytical, conceptual, and political framework of development is changing dramatically. The new development agenda calls for broader understandings of sectors, countries, development strategies, and policies. It emphasizes learning and continuous feedback at all phases of the development cycle. As the development agenda grows in scope and complexity, development evaluation follows suit. Development evaluator are moving away from traditional implementation and output-focused evaluation models toward results-based evaluation models, as the development community calls for results and embraces the millennium development goals. As the development community shifts its focus away from projects in order to comprehensively address country challenges, development evaluators are seeking methods with which to assess results at the country, sector, theme, policy, and even global levels. As the development community recognizes the importance of not only a comprehensive but also a coordinated approach to developing country challenges and emphasizes partnerships, development evaluators are increasingly engaged in joint evaluations. These joint evaluations, while advantageous in many respects, add to the complexity of development evaluation (OECD 2006). Additionally, development evaluators increasingly face the measurement challenge of determining the performance of an individual development organization in this broader context and of identifying its contribution. This text is intended as a tool for use in building development evaluation capacity. It aims to help development evaluators think about and explore the new evaluation architecture and especially to design and conduct evaluations that focus on results in meeting the challenges of development.Publication Impact Evaluation in Practice, First Edition(World Bank, 2011)The Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. The book incorporates real-world examples to present practical guidelines for designing and implementing evaluations. Readers will gain an understanding of the uses of impact evaluation and the best ways to use evaluations to design policies and programs that are based on evidence of what works most effectively. The handbook is divided into three sections: Part One discusses what to evaluate and why; Part Two outlines the theoretical underpinnings of impact evaluation; and Part Three examines how to implement an evaluation. Case studies illustrate different methods for carrying out impact evaluations.Publication Empowerment in Practice : From Analysis to Implementation(Washington, DC: World Bank, 2006)This book represents an effort to present an easily accessible framework to readers, especially those for whom empowerment remains a puzzling development concern, conceptually and in application. The book is divided into two parts. Part 1 explains how the empowerment framework can be used for understanding, measuring, monitoring, and operationalizing empowerment policy and practice. Part 2 presents summaries of each of the five country studies, using them to discuss how the empowerment framework can be applied in very different country and sector contexts and what lessons can be learned from these test cases. While this book can offer only a limited empirical basis for the positive association between empowerment and development outcomes, it does add to the body of work supporting the existence of such a relationship. Perhaps more importantly, it also provides a framework for future research to test the association and to prioritize practical interventions seeking to empower individuals and groups.Publication World Development Report 2004(World Bank, 2003)Too often, services fail poor people in access, in quality, and in affordability. But the fact that there are striking examples where basic services such as water, sanitation, health, education, and electricity do work for poor people means that governments and citizens can do a better job of providing them. Learning from success and understanding the sources of failure, this year’s World Development Report, argues that services can be improved by putting poor people at the center of service provision. How? By enabling the poor to monitor and discipline service providers, by amplifying their voice in policymaking, and by strengthening the incentives for providers to serve the poor. Freedom from illness and freedom from illiteracy are two of the most important ways poor people can escape from poverty. To achieve these goals, economic growth and financial resources are of course necessary, but they are not enough. The World Development Report provides a practical framework for making the services that contribute to human development work for poor people. With this framework, citizens, governments, and donors can take action and accelerate progress toward the common objective of poverty reduction, as specified in the Millennium Development Goals.